mother baby + peds Flashcards

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1
Q

teratogenic drugs

A
TERA-TOWAS 
thalidomide 
epileptic meds (valproic acid, phenytoin)
retinoid (vit a)
ace inhibitors, ARBS
third element (lithium)
oral contraceptives 
warfarin 
alcohol
sulfonamides & sulfones
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2
Q

torch infections

A
infections that can cuase fetal abnormalities 
TORCH
Toxoplasmosis 
parvOvirus-b19 (fifth disease)
Rubella
Cytomegalovirus 
Herpes simplex virus
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3
Q

HELLP syndrome

A
variant of preeclampsia 
LIFE THREATENING COMPLICATION 
Hemolusis 
ELevated liver enzymes 
LP low platelet count
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4
Q

magnesium sulfate

A

remember it acts like a depressant
therapeutic range: 4-7mg/dl

TOXICITY:
RR <12 
decr DTRs
UOP <30 mL/hr 
EKG changes 

ANTIDOTE: calcium gluconate

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5
Q

methergine

A

action: vasoconstriction
- used to prevent or treat bleeding from the uterus after birth or abortion

contraindicated in people with HTN

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6
Q

hemabate

A

prostaglandin. .. helps to control BP and muscle contractions (uterine contractions)
* *usually given btw 13 and 20th week**

CONTRAINDICATED in ppl with ASTHMA

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7
Q

mispostol

A

given rectally

stimulates contraction of the uterine and smooth muscle

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8
Q

what can a baby do at 5 months

A

grasp rattle

**Remember grasp something with 5 fingers, 5 months!

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9
Q

what can a baby do at 12 months

A
  • walks independently
  • sits down from standing position without assistance
  • feeds self finger-foods
  • draws simple marks on paper
  • turns pages in a book
  • receptive language (understands common words independent of context… follows one-step gestured command)
  • expressive language (first word… uses finger to point to things…imitates:gestures&vocal)
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10
Q

signs of delay at 12 months

A

after independent walking for several months

  • persistent tiptoe walking
  • failure to develop a mature walking pattern
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11
Q

signs of delay at 18 months

A

not walking

not speaking 15 words

does not understand the function of common household items

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12
Q

toddler 18 months

A
  • climbs stairs
  • pulls toys
  • stacking
  • removes shoes and socks
  • understands 200 words
  • vocab = 15-20 words
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13
Q

toddler 24 months

A
  • right/left handed
  • scribbles, paints, imitates strokes
  • listens to simple stories
  • “my” “mine”
  • vocab 40-50 words, sentences 2-3 words

delay: cannot push a toy with wheels… or follow basic instructions

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14
Q

4 years old

A
  • uses scissors
  • copies capital letters, draws circle, squares, traces a cross or diamond
  • laces shoes
  • uses language to engage in make-believe
  • count a few numbers
  • 1500 words
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15
Q

5 years old

A
  • skip, swim, skate, climb, swing
  • use utencils
  • mostly cares for own toileting needs
  • count to 10
  • speech gramatically correct
  • 2000 words
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16
Q

peds CPR <12 months

A

CARDIAC ARREST IN INFANTS IS USUALLY D/T RESP ETIOLOGY

  1. checks pulse no longer than 10 seconds
  2. call for help (activate EMS, delagate for someone to call 911/get AED)
  3. chest compressions
    rate 100-120
    ** two fingers/two thumbs on sternum
    **infant 1/3 chest, child 2 inch

single rescuer = 30:2

  1. continue until signs of help arrive or AED is available
17
Q

sensorimotor stage

A

age 0-2

  • development thru 5 senses
  • development thru motor response
  • object permanence
  • egocentric = only see the world from one’s own POV
18
Q

preoperational stage

A

2-7 years

  • symbolic thinking
  • imagination *magical, animism, plays pretend
  • abstract thinking is difficult
  • asks lots of questions
19
Q

concrete operational stage

A

7-11 years

  • develop concrete cognitive operations sorting blocks in a certain order
  • conservation is developed
  • conductive reasoning
20
Q

formal operational stage

A

> 11

  • rational, logical, organized, moral, consistent thinking
  • hypothetical thinking
  • abstract concepts *love, hate, failures, successes
  • deductive reasoning
21
Q

variations in peds anatomy and physiology

A
  • narrow airways
  • nose breathers
  • incr metabolic rate, incr O2 requirements
  • incr risk for ear infections
  • loses heat very easily d/t blood vessels closer to surface
  • head and neck muscles are not well developed
  • brain is highly vascular = incr risk for hemorrhage
  • spine = very mobile = incr risk for cervical spine injury
  • immature immune systems, limited exposure to disease
  • myelinization is incomplete at birth… happens head to tail
  • kidneys are larger in relation to abdomen… less protection… GFR slower
  • incr risk for dehydration
22
Q

SIDS risk factors

A
  • age 1-6 months
  • preterm
  • sleep position
  • sibling death
  • nicotine exposure
  • socioeconomic status
  • lack of prenatal care
  • genetic
  • bedding
  • room temp… cooler = better
23
Q

education/prevention of SIDS

A
  • sleep in supine position
  • firm mattress… no toys, blankets, pillows, stuffed animals
  • avoid overdressing infant
  • no co-bedding
  • normal room temp
  • encourage pacifier use
24
Q

bronchiolitis (RSV)

initial vs continued symptoms

A
  • very contagious, viral illness… starts as URI and moves into chest
    initial
  • upper resp symp (nasal congestion, runny nose, cough, sneezing)
  • fever
    continued
  • lower resp symp (tachypnea, cough, wheezing)
25
Q

emergent bronchiolitis s/s

A
  • grunting
  • nasal flaring
  • cyanosis
  • hypoxia
  • resp failure
  • apneic episodes
26
Q

tx of bronchiolitis

A
  • airway maintenance (o2, suctioning, position at 30-40 degree angle)
  • hydration
  • contact and standard precautions
  • hosp only if severe
27
Q

reyes syndrome

A

rare disease affecting young children recovering from viral illness (flu or chx pox)

  • triggered d/t taking aspirin, alka seltzer, pepto-bismol, kaopectate

s/s

  • encephalopathy/cerebral edema
  • acute fatty liver failure (incr liver enzymes, incr AST + ALT)
CHILDS
Confusion
Hyperreflexia
Irritability 
Lethargy
Diarrhea and vomitting
Seizures
28
Q

intussusception

A

ileum telescopes into the cecum –> obstruction = pain –> compression of blood vessels –> blood flow decr –> bowel ischemia –> rectal bleeding (currant jelly stools)

s/s

  • intermittent pain and cramping
  • draws up legs toward abdomen in severe pain while crying
  • diarrhea and vomitting
  • currant jelly stools
  • lethargy
  • sausage shaped mass
29
Q

tx for intussusception

A
  • IV fluids
  • antibiotics
  • decompression via NG
  • monitor for signs of perforation and shock
  • air or barium enema **
30
Q

pyloric stenosis s/s and tx

A
s/s 
- projectile vomiting
- non-bilious emesis
- olive shape mass palpable in RUQ
- hungry despite reg feeds
- weight loss
- dehydration (incr hematocrit and BUN)
- LEADS TO METABOLIC ALKOLOSIS 
TX
- monitor I/Os, signs of dehydration
- daily weights
- pyloromyotomy
31
Q

epiglotitis cause/s&s/tx

A
- caused by hib + steptococcus pneumonia
s/s
- tripod position 
- drooling/dysphagia 
- retractions, nasal flaring
- stridor
- high fever, sore throat, tachy
TX
- never leave client, assess O2 status, IV access, calm environment, NPO, do not put in supine position 
- meds
** antibiotics, antipyretics, corticosteriods, iv fluids

DO NOT PUT TONGUE BLADE IN MOUTH, NO ORAL TEMPS OR THROAT CULTURE

32
Q

resp condition like croup indicating you need to seek help

A

PT IN RESP DISTRESS

  • child is confused/restless
  • blue lips/nails
  • incr resp rate
  • retractions
  • nasal flaring
  • drooling/can’t swallow
33
Q

causes and s/s of croup

A

causes: parainfluenza virus… leads to inflamation of larynx, trachea and bronchi

s/s
inflammation and edema obstruct airway 
stridor
subglottic swelling (hoarseness in voice)
seal bark cough
34
Q

fever management of kid

A
antipyretics (ibuprofen)
s/s of dehydration and electrolyte imbalances
sponge bath
remove excess clothing to decr temp
cool compress on forehead
35
Q

febrile seizure risk factors, s/s and tx

A

seizures associated with a fever NOT R/T intracranial infection, metabolic imbalance, viral illness

s/s 
rapid incr in core temp, child may be drowsy in postictal period
risk factors
6 months-5 yrs
rapidly developing, HIGH fever
family hx 
certain vaccines = DTP and MMR
tx
NOT anticonvulsant therapy
rectal diazepam
educate parents to seek help if >5 mins + repeat
36
Q

CF patho and diagnosis

A
  • excrine gland disorder w incr production of thick mucus
  • autosomal recessive
  • leads to mucous plugging
    diagnosis
  • ambry test
  • positive sweat sodium chloride test
  • genetic screen
37
Q

tx of CF

A

PANCREATIC ENZYMES

  • chest PT… not done right after meals… helps to break up mucus and strengthen resp muscles
  • nebulizers
  • prevent GI blockage w fluids and stool softeners
  • incr protein, fat, calories, fat soluble vitamins
38
Q

scarlet fever s/s

A

complication of group A streptococcal infection
- transmitted via droplets and resp tract secretions
S/S
- onset = abrupt
- red rash –> sandpaper like rash not usually seen on palms and soles of feet
- pharyngitis
- fever, body aches, chills
- strawberry tongue
- tender cervical nodes
- tonsils red
- exudate present

39
Q

complications + tx of scarlet fever

A
complications
- rhematic fever
- glomerulonephritis
- abscesses of throat
- pneumonia 
TX
- antibiotics *penicillin v* *erythromycin for those allergic*
- fluids and soft foods
- comfort
- cool mist humidifier